Calcium channel blockers (versus unexposed)

Low birth weight (< 2500g)

R analysis
id Study   Lib. in paper Exposition period    Study type  Control type 
 
Tags OR 95%CI x1/n1 x0/n0 no cases no exposed ROB Ref.
S13513
R52199
Fitton - Calcium blockers (Controls unexposed, disease free), 2020 Low birth weight (<2500 g) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, disease free excluded Adjustment: Yes Indications Antihypertensive: All hypertensions, any indications or not specified 1.24 [0.55;2.78]
excluded (control group)
26/167   11,051/250,693 11,077 167
ref
S14422
R57251
Fitton - Calcium blockers (Controls unexposed, sick), 2020 Low birth weight (<2500 g) during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: No Indications Antihypertensive: All hypertensions, any indications or not specified 1.66 [1.09;2.54] C 26/167   797/7,971 823 167
ref
S13387
R52259
Mito - Amlodipine, 2019 Low birth weight (<2500 g) at least 1st trimester retrospective cohort unexposed, sick Adjustment: No Indications Antihypertensive: Only chronic hypertension indication 0.54 [0.26;1.15] C 12/48   49/129 61 48
ref
S13449
R51811
Su - Calcium blockers (Controls unexposed, disease free), 2013 Low birth weight (< 2,500 gm) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, disease free excluded Adjustment: No Indications Antihypertensive: Only chronic hypertension indication 2.19 [1.50;3.20] C
excluded (control group)
32/303   418/8,181 450 303
ref
S13443
R51793
Su - Calcium blockers (Controls unexposed, sick), 2013 Low birth weight (< 2,500 gm) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes Indications Antihypertensive: Only chronic hypertension indication 1.50 [0.97;2.33] 32/303   76/1,006 108 303
ref
S13969
R54754
Parazzini - Nifedipine, 1998 Birthweight < 2500 g 2nd and/or 3rd trimester randomized controlled trial unexposed, sick Adjustment: Randomisation Indications Antihypertensive: All hypertensions, any indications or not specified 1.09 [0.64;1.87] C 40/129   37/127 77 129
ref
Total 4 studies 1.20 [0.80;1.79] 1,069 647
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

StudyTE95% CIn casesn exposedweightROBABCDEF Fitton - Calcium blockers (Controls unexposed, sick), 2020Fitton - Calcium blockers, 2020 1 1.66[1.09; 2.54]82316729%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: moderateROB mesure: moderateROB reporting: moderate Mito - Amlodipine, 2019Mito - Amlodipine, 2019 0.54[0.26; 1.15]614818%ROB confusion: seriousROB selection: criticalROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Su - Calcium blockers (Controls unexposed, sick), 2013Su - Calcium blockers, 2013 2 1.50[0.97; 2.33]10830329%ROB confusion: seriousROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Parazzini - Nifedipine, 1998Parazzini - Nifedipine, 1998 1.09[0.64; 1.87]7712925%ROB confusion: lowROB selection: unclearROB classification: moderateROB missing: lowROB mesure: moderateROB reporting: moderate Total (4 studies) I2 = 59% 1.20[0.80; 1.79]1,0696470.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick; 2: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.20[0.69; 2.08]99251871%NAFitton - Calcium blockers (Controls unexposed, sick), 2020 Mito - Amlodipine, 2019 Su - Calcium blockers (Controls unexposed, sick), 2013 3 case control studiescase control studies 0 RCTRCT 1.09[0.64; 1.87]77129 -NAParazzini - Nifedipine, 1998 1 Type of controls unexposed, sickunexposed, sick 1.20[0.80; 1.79]1,06964759%NAFitton - Calcium blockers (Controls unexposed, sick), 2020 Mito - Amlodipine, 2019 Su - Calcium blockers (Controls unexposed, sick), 2013 Parazzini - Nifedipine, 1998 4 Tags Adjustment   - No  - No 0.99[0.33; 2.95]88421585%NAFitton - Calcium blockers (Controls unexposed, sick), 2020 Mito - Amlodipine, 2019 2   - Randomisation  - Randomisation 1.09[0.64; 1.87]77129 -NAParazzini - Nifedipine, 1998 1   - Yes  - Yes 1.50[0.97; 2.32]108303 -NASu - Calcium blockers (Controls unexposed, sick), 2013 1 Indications Antihypertensive   - All hypertensions, any indications ...  - All hypertensions, any indications or not specified 1.39[0.93; 2.09]90029630%NAFitton - Calcium blockers (Controls unexposed, sick), 2020 Parazzini - Nifedipine, 1998 2   - Only chronic hypertension indication  - Only chronic hypertension indication 0.95[0.35; 2.55]16935181%NAMito - Amlodipine, 2019 Su - Calcium blockers (Controls unexposed, sick), 2013 2 All studiesAll studies 1.20[0.80; 1.79]1,06964759%NAFitton - Calcium blockers (Controls unexposed, sick), 2020 Mito - Amlodipine, 2019 Su - Calcium blockers (Controls unexposed, sick), 2013 Parazzini - Nifedipine, 1998 40.25.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-0.91.10.4550.000Fitton - Calcium blockers (Controls unexposed, sick), 2020Mito - Amlodipine, 2019Su - Calcium blockers (Controls unexposed, sick), 2013Parazzini - Nifedipine, 1998

Asymetry test p-value = NaN (by Egger's regression)

not enought points

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 13449, 13513

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 1.85[1.11; 3.09]11,52747036%NAFitton - Calcium blockers (Controls unexposed, disease free), 2020 Su - Calcium blockers (Controls unexposed, disease free), 2013 2 unexposed, sick controlsunexposed, sick controls 1.20[0.80; 1.79]1,06964759%NAFitton - Calcium blockers (Controls unexposed, sick), 2020 Mito - Amlodipine, 2019 Su - Calcium blockers (Controls unexposed, sick), 2013 Parazzini - Nifedipine, 1998 40.510.01.0